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Qualifications:
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- Graduate of an accredited school of professional nursing and licensed to practice as a registered nurse in the State of California
- Current BLS certification
- Minimum of five years of recent clinical experience
- Desired Bachelor or Associate Degree in Nursing
- Experience in acute clinical case management and/or utilization review
- Experience in a related duties in the delivery of patient care, management of patient care providers, or project management in a healthcare environment
- Current licensure in good standing with the California Board of Registered Nursing
- Experience leading and developing clinical practice within a person–centered framework
- Medical Surgical experience, demonstrates knowledge of and experience with current best practices in critical care nursing.
- Ability to maintain all Standards of Oroville Hospital in conjunction with the Director.
- Demonstrate the ability to work in partnership with people balancing the needs of people with one’s own clinical and professional responsibilities.
- Demonstrates effective interpersonal skills, including active listening, to influence others, build constructive relationships and achieve outcomes.
- Demonstrates critical thinking skills using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
- Can analyze complex issues, propose solutions and implement decisions in conjunction with the Director.
- Welcomes change and is committed to encouraging continuous improvement and learning.
- Ability to accept and delegate responsibility, make sound judgments and accurately assess when to refer issues to the Director.
- Manages own workload effectively while being flexible to new demands.
- Demonstrates a high level of oral and written communication.
- Demonstrates effective computer skills.
- Has the ability to integrate well with, and contribute to, an evolving management team.
- Willing to travel and to work outside normal hours, where required.
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Duties &
Responsibilities:
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Job Summary
The Clinical Supervisor will be responsible for leading the development of an integrated nursing team approach. They will work directly with the Director in development of the Director of Discharge Planning/Case Management including education, department competencies, evaluation, performance correction, patient safety and customer service related issues. The goal is to achieve clinical, financial, and utilization goals through effective management, communication and role modeling. The Clinical Supervisor for Discharge Planning/UM/Plumas House functions as the internal resource on issues related to the appropriate utilization of resources, coordination of care across the continuum and utilization review and management. The Clinical Supervisor for Discharge Planning/UM/Plumas House is responsible for carrying out assignments in a manner to assure success in financial management, human resources management, leadership, quality and operational management objectives. The Clinical Supervisor for Discharge Planning/UM/Plumas House participates in program development and unit performance improvement. The Clinical Supervisor for Discharge Planning/UM/Plumas House consistently demonstrates the core values of Oroville Hospital and serves as a role model to other employees. The Clinical Supervisor for Discharge Planning/UM/Plumas House adheres to the Oroville Hospital Mission Statement, which is to provide high quality, cost effective healthcare for the people in the communities served.
Duties
Clinical Support
- Support and advise on efficient clinical practice of nursing staff ensuring appropriate skill mix to promote the highest standard of service.
- Assist people who use the services to evaluate their health outcomes and adjust nursing care practices to ensure optimum co-ordination and delivery of care.
- Review and recommend alterations in prescribed clinical options along agreed protocol driven guidelines.
- Review department documentation and maintain standards with regards to hospital policy on documentation including educating nursing staff to documentation standards.
- Identify the training needs of Discharge Planning and UM staff and facilitate how to appropriately meet those needs.
- Facilitate clinical practice training, in line with Oroville Hospital’s values and ethos, to Discharge Planning/UM /Plumas House staff as required.
- Foster an atmosphere conducive to learning in all grades of staff within the service.
- Establish and maintain communications with appropriate educational bodies and to liaise with like Services/Specialties nationally and internationally including any other group that will enhance clinical development.
- Ensures that the UR component of the UM Department are completed as described in the UR Plan
- Completes daily reviews on all patients and oversees the completion of those reviews to all requesting insurance companies per contract agreement
- Updates the UR Plan to meet CMS requirements for Condition of Participation
- Receives all denials for care involving patient stays, discusses with UR Physician Advisor, feasibility to appeal. Manages all appeals related to denials of patient stays for all payors/insurance companies
- Participates in quality improvement processes and assures implementation of regulatory standards
- Ensures service is provided considering the age-specific physiological, emotional and cognitive needs of the patients served
Professional Support/Supervision:
- Provide leadership in clinical practice and act as a resource and role model for clinical practice.
- Provide leadership, supervision and support to nursing and care staff in the provision of clinical/care support services in a professional manner.
- Develop and maintain good collaborative working relationships and channels of communication with members of the nursing and care staff teams including all ancillary departments.
- Monitor, evaluate, and correct staff performance relating to care/clinical practice and assist the Director in raising the standards of practice.
- Assist in coordinating daily staffing to ensure that all shifts are covered.
- Attend management and other meetings as required by Oroville Hospital.
- Attend management development or training events organized or specified by Oroville Hospital.
- Act as a role model.
- Keep up to date with current developments in nursing practice and education.
- Ensure adherence to clinical policies and patient care guidelines at Oroville Hospital.
- Be on call as assigned by the Director.
- Undertake any other reasonable duties which may be assigned to you by the Director.
Skills/Knowledge/Abilities:
- Current Knowledge of case management, care coordination and utilization review processes
- Shall have knowledge of or ability to learn financial management related to UR function and reporting, quality improvement processes, and human resources management
- Shall be able to effectively monitor, evaluate, and administer the resources of each assigned area, and make substantiated recommendations regarding resource allocation needs for future planning purposes
- Shall be able to communicate effectively in writing and verbally
- Shall be able to lead, delegate, analyze information and problem solve
- Shall demonstrate evidence of strong skills in confidentiality, integrity, creativity, and initiative
- Demonstrate ability to interact with a wide variety of individuals, and handle complex and confidential-sensitive situations
- Proficient in the use of computer and multiple software programs
- Ability to actively work within Vista electronic health record
- Ability to work closely with Hospitalist Program and Physicians and Active Medical Staff
- Ability to work with other areas of Patient care including outpatient, emergency services, home health and public health
- Knowledge of scheduling and allocation of resources to best achieve effective patient care, and employee resources
- Ability to identify trends through analysis of practices to improve the overall utilization of resources and cost containment
- Ability to communicate those trends found through analytical study using a variety of reporting mediums
- Ability to perform utilization review as described in the UR Plan
- Ability to assist and coordinate appeal efforts when medical care is denied by various payor entities in a timely fashion
- Ability to make recommendations for practice change to improve the Utilization Management efforts of the department
- Ability to represent UM/Case Management in Medical Staff Committees as assigned
- Other duties as assigned
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